Gynaecologic Laparoscopic Surgery Using Spinal Anaesthesia - A Retrospective Observational Study
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Date
2020-03
Journal Title
Journal ISSN
Volume Title
Publisher
Akshantala Enterprises Private Limited
Abstract
Laparoscopy is traditionally done under General Anaesthesia (GA) with endotracheal intubation. As the number of cases of laparoscopy increased over the years, regional anaesthesia has been quite frequently used for laparoscopy.METHODSA total of 495 cases of laparoscopic surgeries done in the age group 12 to 47 years during the period August 2015 till September 2019 was considered. Spinal anaesthesia was administered with 25G spinal Needle at L4-L5 intervertebral space with 3-4 ml bupivacaine (0.5%, heavy) and the surgeries were completed. The segmental level achieved was T-6. Intra-abdominal pressure after CO2 insufflation for pneumoperitoneum was maintained at 10-12 mmHg. Post-operative monitoring was done.RESULTSOnly 15 cases (3%) required midazolam. 2 patients stayed for >48 hrs post-surgery (0.4%). 4 GA cases required immediate analgesic infusion. In SA cases, analgesic was required almost 2-3 hours after the surgery was over. Onset of bowel sounds was early with SA cases. In the 4 GA cases (0.8%) PONV was noted. Two patients (0.4%) had spinal headache. 6 patients experienced post laparoscopic shoulder pain (1.21%).CONCLUSIONSSpinal Anaesthesia provides a good field for gynaecologic laparoscopic surgery with excellent muscle relaxation, decreased surgical bed oozing, and a rapid return of gut function, good post-operative analgesia, and decreased incidence of PONV than GA.
Description
Keywords
Laparoscopy, Gynaecology, Spinal Anaesthesia
Citation
Chilkund Jayanth Nagendranath, Gadgil Jeevan Jayant. Gynaecologic Laparoscopic Surgery Using Spinal Anaesthesia - A Retrospective Observational Study. Journal of Evolution of Medical and Dental Sciences. 2020 Mar; 9(12): 924-927